Abstract

Purpose. Branch retinal artery obstruction with simultaneous central retinal vein occlusion (BRAO/CRVO) is a rare condition. We describe 3 cases of BRAO/CRVO successfully treated with hyperbaric oxygen (HBO) and subcutaneous nadroparin calcium.
Methods. The first patient, a 42-year-old man, developed sudden visual loss (hand-motion) in his left eye one day after tonsillectomy. The second patient, a 60-year-old man with hypercholesterolemia, complained of sudden visual loss (finger counting) in his left eye upon arising. The third patient, an apparently healthy 39-year-old bricklayer, noted an acute decrease in his left vision (20/70) while working. In all patients, fundus evaluation and fluorescein angiography revealed BRAO/CRVO.
Results. All patients were treated with HBO at 2.5 atmospheres (15-20 sessions) and subcutaneous nadroparin calcium (200 UI/Kg/die) for 6 weeks. Two months later, there was complete resolution of the clinical signs of BRAO/CRVO and left visual acuity was 20/25 in patient 1, 20/32 in patient 2, and 20/20 in patient 3. Patient 2 had an improvement in the left visual field, but there was still a discrete cecocentral scotoma.
Conclusion. In these 3 patients with BRAO/CRVO, vision returned to near normal after prompt treatment with HBO and subcutaneous nadroparin calcium. We have to acknowledge that the effect of our intervention cannot be determined from 3 cases and no control. Nevertheless, a comparison between our results and those reported in similar cases seem to suggest that this therapy may be beneficial in the management of BRAO/CRVO.